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应激相关精神障碍的病理生理机制研究进展

A Review of Research Progress in the Pathophysiological Mechanism of Stress-related Mental Disorders

  • 摘要: 应激可以提高个体适应环境变化的能力,然而,过度的应激可诱发包括焦虑障碍、抑郁障碍和创伤后应激障碍(post-traumatic stress disorder,PTSD)等在内的应激相关精神障碍。应激可通过脑网络和神经环路、下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis,HPA)以及交感神经系统等调控机体激素、免疫炎症水平,还可通过调控基因、转录、蛋白和代谢等水平的分子改变,导致精神障碍的发生。脑-肠轴在应激相关精神障碍发病机制中也扮演着重要的角色。然而,应激相关精神障碍确切的病理生理机制尚未阐明,其发病与个体生理和心理素质密切相关,同时该类疾病又与其他精神和躯体疾病相关联。因此,有必要对个体病前素质开展研究,以及从疾病不同阶段进行深入的临床医学、基础医学和心理学研究,以期进一步阐明应激相关精神障碍的发病机制。

     

    Abstract: Stress can improve an individual’s ability to adapt to environmental changes. However, excessive stress can induce stress-related mental disorders, including anxiety disorder, depression disorder and post-traumatic stress disorder (PTSD). Stress can regulate the level of hormones and immune inflammation in the body through the brain network, neural circuits, hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, thereby causing the occurrence of mental disorders. In addition, stress can mediate the occurrence of mental disorders by regulating molecular changes in the level of genes, transcription, protein and metabolism, etc. Studies have shown that the brain-gut axis also plays an important role in the pathogenesis of stress-related mental disorders. However, the pathophysiological mechanism of stress-related mental disorders remains unclear. Besides, studies have also shown that the onset of stress-related mental disorders is closely associated with the individual's physiological and psychological qualities,which has a cross-talk with other mental and physical diseases as well. Therefore, it is important to study individual premorbid diathesis clinical, and to conduct clinical medical, basic medical, and psychological studies of the different stages of the disease, so as to obtain further understanding of the pathogenesis of stress-related mental disorders.

     

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